{
"Npi": {
"NPI": "1497701445",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FAIRPORT ENTERPRISES, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "8181 WORTHINGTON RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WESTERVILLE",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "43082-8067",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "614-794-8800",
"MailingAddressFaxNumber": "614-794-8826",
"FirstLinePracticeLocationAddress": "2000 SHERMAN CIR NE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MASSILLON",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44646-5219",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "330-830-9988",
"PracticeLocationAddressFaxNumber": "330-830-0039",
"EnumerationDate": "05/25/2006",
"LastUpdateDate": "06/17/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KHAN",
"AuthorizedOfficialFirstName": "ANIS",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CFO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "614-794-8800",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "313M00000X",
"TaxonomyName": "Nursing Facility/Intermediate Care Facility",
"LicenseNumber": "2082N",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "2082N",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}